Individual
RUSSELL DUANE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
2 GATEWAY DR, SAINT LOUIS, MO 63106-2715
(314) 241-0993
Mailing address
905 BOONE ST, FLORISSANT, MO 63031-4612
(314) 835-8471
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2018027106
MO
Other
Enumeration date
07/25/2018
Last updated
07/25/2018
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